I had an interesting day yesterday. I should have been at the ABM Conference but due to waiting for a baby, this doula was stuck in Cambridge, so I attended a local parenting show. There were a few exhibitors in our local town hall so I had a little wander around to see who was there.
Now, as a Breastfeeding Counsellor, anything specifically targetted at the pockets of breastfeeding families always attracts my attention. After all, one of the huge plus points of using your boobs to feed your baby is that it is completely and utterly free. People may try to tell you that you need expensive creams, lotions, potions, cushions, pumps and whatnot, but actually, the vast majority of us, with good information and loving, skilled support, get on perfectly well with a comfy bra and someone to hand us a cup of tea from time to time.
Neither do we need special foods or drinks. In fact we hardly even need any extra calories when lactating. Oxytocin, the hormone that ejects the milk, has an effect on hunger and thirst, so breastfeeding mums tend to naturally consume a little more food and drink while nursing. So it’s not something we generally have to consciously think about.
But if companies want to flog us stuff and mums want to buy it, what’s the big deal? Seems like us breastfeeding ‘loonies’ have always got our knickers in a twist about something! If we’re not complaining about the way formula manufacturers undermine a mother’s choice and ability to breastfeed, we’re setting our sights on companies who are actually trying to HELP nursing mothers. I know, I know, I should just shut up – they mean well and are just trying to make a living.
Well here’s the thing. I can’t shut up. Your cheap cereal bar with fennel seeds in it, that’s sending a message. A message that says:
You won’t make enough milk, love. You need help. Help from us. From these expensive packages, made from ingredients that you could buy for yourself in any supermarket, for a fraction of the cost. Milk supply isn’t about sound knowledge of lactation management and an understanding of supply and demand. Oh no, your supply depends on how many of our delicious bars you can afford to stuff down your neck.*
But at least the cereal bar pushers only had one negative message about breastfeeding. The next company I came across had three! Here were 2 midwives offering aromatherapy products. I was stopped in my tracks by the prominent display of the ‘Breastfeeding Survival Kit’. Apparently, breastfeeding isn’t something to enjoy and exult in, but something to be endured, to “survive”.
3 oil blends for sore nipples, engorgement and low milk supply. Called, of all things, Ooh, Ahhh and Ouch. I wanted to know more. It sounds lovely and soothing: you put a few drops in water, soak your flannel, squeeze it out and put it on your breast. For 20 mins. While relaxing. What’s not to love?
Yep, I’m sure it’s lovely. But, I wondered, how could it help damaged nipples? I asked how this was meant to achieve moist wound healing. They didn’t seem to understand what I was getting at. So I tried again. “Once you take off the flannel and put your boobs back in your bra the skin on your nipples is going to dry out and make scabs. You need something gloopy like lanolin if the skin is broken. I was told that the essential oils in this blend had been proven to be more effective than lanolin. Mmmm I’d like to see that study. I was met with blank looks. It seems I was talking to 2 trained midwives who had no idea why allowing a traumatised nipple to dry out is a bad idea. No idea at all.
Here’s the message:
You will get sore, damaged nipples. You will need to sit for 20 mins, after each feed, with flannels on your poor, bleeding bazongas. Breastfeeding hurts. You need a product called OUCH, cos nursing blooming hurts. Don’t get support, just BUY THIS PRODUCT.
At least it mentions in passing on the website that ‘correct positioning’ will help. But no signposts to skilled support. When I asked why, I was told “that’s the midwife’s job”. I couldn’t help but make the point that if more midwives were skilled in supporting good positioning and attachment, there would be fewer women with sore nipples. But, apparently, there are some babies who just have a ‘strong suck’ and make their mums sore, despite a good latch. Really? It was it this point I began to lose the will to live.
Then we come to engorgment. Apparently, it matters not whether you use warm or cold water for your flannel. Really? But engorgement is caused by edema (swelling). How would you treat a swollen ankle? Yes, that’s right. A COLD flannel will feel wonderful during those few days after your milk comes in if your boobs are feeling hot, hard and full. With a little Reverse Pressure Softening and perhaps then a nice warm compress, your milk should start to flow and your baby should be able to latch deeply and comfortably. Yet none of this information is forthcoming from the company or in it’s product information or in the packaging.
Here’s the message:
Your Girls will balloon to the size of watermelons. It will HURT. Breastfeeding is difficult and embarrassing. Don’t get support, just BUY this product.
Next, milk supply. Ahhh! Good old milk supply. The most common fear, the most oft quoted reason for being unable to breastfeed. I was patronisingly told that milk supply “is the most common problem”. Again, really? Or is that one big, fat misunderstanding of the most common reason for switching to bottles: perceived insufficiency of supply?
In other words, everyone and his wife keeps telling me I won’t have enough milk, so I probably don’t. Better chuck money at the problem. Eat expensive bars and drape myself with wet flannels with some drops of essential oil and hope for the best.
To give this company their due, the website does explain that more breastfeeding leads to more milk but the essential message is clear:
You won’t have enough milk. BUY this product. Don’t get support, just BUY this.
You know, I’m sure their heart is in the right place. I’m sure a wet, nice-niffing flannel feels good on the ol’ norks in the early days of nursing. But these insidious messages, intended or not, UNDERMINE breastfeeding.
We deserve more from our public servants. These women are midwives. If you are a midwife, you have a responsibility to provide the public with evidence-based information. That’s a fancy way of saying FACTS. You have a responsibility to know your subject. In depth. And to seek support and help from other professionals in your field. To check your work supports, informs and is theraputic. To be sure your work does not undermine or damage.*
I’m bored and tired of letting people like this off because they are nice ladies, trying to earn a crust. I’m fed up of women trading on the midwife label their whole lives because it lends them credibility with the public and I’ve had enough of so many midwives knowing naff-all about breastfeeding.
I’m sorry, but trying to be ethical and kind does not let you off the hook. I’m afraid the message you send out adds to the tsunami of negative messages about breastfeeding that bombard mothers every day.
I’m afraid if you are not part of the solution, you are part of the problem.
*This is my action for #MatExp: I usually keep my mouth shut and my head down, but the great work of others has given me the gumption to speak my mind.
*There are so many amazing midwives working with love, integrity, passion and skill. My rant is absolutely not directed at them. In fact, the very reason I get so ranty is because I think stuff like this casts a shadow over the sacred art and science of midwifery.
* I am editing this post with a few of thoughts on safety:
1. The breastfeeding relationship, especially in the early days, is very much dependent on smell. The baby uses his excellent sense of smell to to find the nipple. Smelling of essential oils MAY get in the way of the two of you coming together easily and comfortably.
2. Peppermint is a known anti-galactogogue. That means it has the potential to lower your milk supply. While this MAY be ok in the blend for engorgement, use with caution. For other problems, you may wish to avoid peppermint altogether.
3. It appears that these oils come in a bottle mixed with a carrier oil. The instructions are to drop a few drops of the oil into a bowl of water. As it is not mixed with a solubiliser, the oil may float on top of the water and be transfered to the flannel and then your breast in very concentrated amounts. Be careful. Especially on the nipple and areola area – ingesting essential oils is not a good idea. It seems the blend designed for sore nipples is intended to be applied to the nipple area. If the skin on your nipples is broken, please be extra careful – essential oils in the wounds may hurt. Wounds on your nipple really need to be cared for with a small smear of purified lanolin or vaseline to ensure ‘moist wound healing’.
4. If you like the sound of using essential oils for anything other than to have a nice smelly bath or to pop in your massage oil, you may find you get more theraputic effect from consulting a fully qualified aromatherapist.
*Edited to add: This report on cereal bars for mothers by First Steps Nutrition makes for interesting and useful reading.
September 2016. I’m adding an update to this post. I have recently been in communication with the essential oils company and their PR lady. Some positives and negatives have emerged:
1. The word ‘survival’ is no longer being used on their packaging. So at least now they are not perpetuating the subliminal message that breastfeeding is something to be endured.
2. There are now mentions of some (not all) of the breastfeeding support available from the breastfeeding charities in the UK on their website. Well done – I hope my call for the missing info is remedied soon.
3. It appears my long explanation of moist wound healing has been heeded and they have accepted that this is the best way to treat cracked nipples. On the other hand, I am told their product is not to be used on skin that is broken, but just on ‘sore’ nipples. As there are MANY reasons a nipple could be painful, I still fail to see how a standard treatment could be recommended, without getting to the bottom of why those nips are ouchy.
3. On the not so positive front, none of my concerns have been addressed. No evidence for the efficacy of the products has been forthcoming. As the products make therapeutic claims, I have asked if they have a licence to market as such or just a cosmetic licence. I have yet to have an answer. A PR women telling me she used the product and loved it is really no substitute for solid evidence.
4. Since I first wrote this piece, they have started blogging on their site. An article about low milk supply was full of factual errors, which I took 2 hours to write them a long letter explaining and suggesting improvements, with links to evidence and further reading. As yet I have had no reply – rather the PR company has told me they see no benefit in further engagement with me. Apparently, a breastfeeding counsellor trying to be friendly and helpful needs to be ignored.
5. I am STILL being asked to edit this blog. As consumers have the right to air their views, write reviews and voice their opinions, I’m not sure why this is. Handling this in a different way could have made me a fan – after all, as they say, we should all be on the same side. But sadly I have to stand by my comment above – if you ain’t part of the solution, you are part of the problem.